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Relationship Between the Urine Flow Rate and Risk of Contrast-Induced Nephropathy After Emergent Percutaneous

Yong Liu1, Lixia Lin, Yun Li

  • 1From the Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China (YL, LL, YL, HL, D-XW, J-BZ, DL, YZ, YL, PY, PR, SC, JC, NT); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China (CD, SC, PC); Department of Biostatistics, South China College of Cardiovascular Research, Guangdong Society of Interventional Cardiology, Guangzhou, China (SC); Duke Clinical Research Institute, Durham, North Carolina, USA (YX).

Medicine
|December 20, 2015
PubMed

Insights

Both very low and very high urine flow rates increase the risk of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). A moderate urine flow rate is associated with a reduced risk of CIN and mortality.

Area of Science:

  • Nephrology
  • Cardiology
  • Critical Care Medicine

Background:

  • Low urine flow rate is a known marker for acute kidney injury.
  • The association between high urine flow rate and contrast-induced nephropathy (CIN) risk in high-risk patients remains unclear.

Purpose of the Study:

  • To evaluate the predictive value of postprocedural urine flow rate for CIN risk in patients undergoing emergent percutaneous coronary intervention (PCI).

Main Methods:

  • Prospective examination of 308 patients undergoing emergent PCI.
  • Assessment of 24-hour postprocedural urine flow rate adjusted by weight (UR/W) in mL/kg/h, divided into quartiles.
  • Multivariate logistic regression analysis to determine the predictive value of UR/W for CIN risk.

Main Results:

  • The cumulative incidence of CIN was 24.4%.
  • Both low (Q1: ≤0.94 mL/kg/h) and high (Q4: ≥1.71 mL/kg/h) urine flow rates were significantly associated with increased CIN risk (OR 2.23 and 2.69, respectively) compared to moderate flow rates (Q2+Q3).
  • A moderate urine flow rate (0.94-1.71 mL/kg/h) was associated with a decreased risk of in-hospital mortality.

Conclusions:

  • Both low and high urine flow rates are significant risk factors for CIN following emergent PCI.
  • A moderate urine flow rate (0.94-1.71 mL/kg/h) may be associated with a reduced risk of CIN and improved prognosis after emergent PCI.

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